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OBJECTIVE To investigate the development of individual therapy of antimicrobial agents in pediatric patients. METHODS A questionnaire survey was conducted to investigate the individual therapy of antimicrobial agents in 30 children’s hospitals and pediatric departments of general hospitals in China. The survey data was analyzed statistically by Microsoft Excel 2007 and SPSS 26.0 software. RESULTS In this survey， 75 questionnaires were collected， and 53 of them were valid with an effective rate of 70.7%. The results showed that 86.7% （26/30） of the hospitals carried out individual therapy of antimicrobial agents in different forms. Clinical needs primarily contributed to the individual therapy in these hospitals， while the insufficient personnel and equipment were the biggest obstacles for individual therapy. The proportions of hospitals， who implemented evidence- based pharmacy， therapeutic drug monitoring （TDM）， model-informed precision dosing （MIPD） and antimicrobial-related genetic tests were 70.0%， 80.0%， 30.0% and 33.3%， respectively. Various detection methods of TDM were carried out in various hospitals， and the antimicrobial agents which needed TDM focused on vancomycin and voriconazole. Moreover， nearly half of pharmacists did not know much about MIPD. CONCLUSIONS At present， TDM is the main way to develop individual therapy of antimicrobial agents in various hospitals， but its monitoring coverage and testing standards need to be improved. MIPD and antimicrobial-related gene tests still need to be further promoted in clinical practice.
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Glaucoma is a common blinding eye disease mainly characterized by optic nerve damage.Lowing intraocular pressure is still the main managing method of glaucoma up to now.However,although the intraocular pressure is reasonably controlled,optic nerve damage is difficult to recovery and sustainable development in some patients.Therefore,the pathogenesis and prevention and treatment of glaucoma have always been the hot spot of the research of glaucoma in recent years.Even though the big progresses have been made in the experimental research of optical nerve injury and repair,little good evidence has been seen in the clinical management of glaucoma neuroprotection.In recent years,genomics study,stem cells study,molecular biological study,electronic technology application in medical research,especially the rise of big data era laid a good basis for the neuroprotection of glaucoma.Ophthalmologists should focus on new insights into the potential and beyond impact factors in the precise individual therapy of glaucoma neuroprotection.
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Precision medicine is a new developing area of medical research and clinical practice, which is stemmed from the urgent need for high-profile medical health care and fast emergence of exquisite biological and medical technologies.Precision medicine, mainly based on the individualized molecular medicine and sophisticated medical techniques, offers multiple dimensional imaging examinations and biological molecular assays to make subsequent therapeutic strategies much more optimized to the personal disease characteristics than the traditional regimes, hence pursuing maximized efficacy and minimized side effects.The precision medicine in China is stepping into a vigorously developing stage after its first official initiation.This review summarized the development and program design of precision medicine in China to shed light on this growingly progressing area.
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Recently,clinicians pay more and more attention to the treatment effects related to individual differences.Individualized treatment of hepatic carcmoma is becoming the focus of clinical treatment and basic research increasingly.The individualized treatment of surgery,chemotherapy with radiotherapy,targeted therapy,immunotherapy and gene therapy have become new ways for further improving the prognosis of liver cancer.
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<b>Purpose</b>: As integrated medicine has been receiving more attention, therapeutic effect of plants has become more evident in recent years. However, many hospitals in Japan have not taken advantage of horticultural therapy in their palliative care unit yet. In the present study, we examined the role and the experience of horticulture as an individual therapy for patients in palliative care unit. <b>Results and Discussion</b>: More smiles were observed on the patients as evident from their Face scale score changes on days horticultural therapy was conducted. Coming into contact with the vital force of plants, through germination, flowering, and seed setting seemed to act as an effective care for the patients. Comparison of the nurses' daily journal and horticultural therapists' logbook showed difference in the nature of conversations recorded, indicating a specific role of horticultural therapists in palliative care. <b>Conclusion</b>: The study suggested a potential for individual therapy of patients with horticulture in palliative care as a part of integrated medicine that requires involvement of multiple medical disciplines.
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Objective To report a simple formula to estimate phosphate removal by standard four-hour hemodialysis in Chinese patients.Methods A total of 165 MHD patients in Huashan Hospital were enrolled.Effluent dialysate samples were collected during treatment to estimate the total amount of phosphate removal.Pre-dialysis levels of serum phosphate,potassium (K+),hematocrit(Hct),parathyroid hormone(iPTH),carbon dioxide combining power(CO2CP),alkaline phosphatase (AKP),Kt/V,and ultrafiltration volume,age,gender,dry body weight,blood flow,phosphate clearance of dialyser,phosphate concentration of dialysate at 60 min after the start of HD were obtained.80％ observations were randomly selected for formula building by backward stepwise and the remaining 20％ observations were used to validate the formula.Results The formula was described as Tpo4 =88.6 ×C60-0.03 ×Age + 1.07 ×Gender +0.06 ×Clearance-4.59,where C60 was phosphate concentration in dialysate measured 60 min into HD and Clearance was the phosphate clearance of dialyser.Formula validation further suggested good predictive ability.Conclusion This study derives an approach to quantify phosphate removal by a simple formula,which will be helpful for clinicians to treat patient individually.
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Chemotherapy plays an important role in advanced colorectal cancer. Patients may show various clinical response to selection different drugs. The importance of individual therapy based on pharmacogenomics has been emphasized in cancer therapy. To explore the individual therapy of colorectal cancer, the progress of molecular markers which influence the efficacy of anti-tumor drugs containing fluorouracil, oxaliplatin, CPT-11, monoclonal antibody drugs is reviewed in this article.
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Since the first description of tension-free herniorrhaphy and the developement of prosthetic ma-terial for inguinal hernia, many techniques have come and gone. We should deploy the idea of evidence-based medicine and clinical practice guideline, according to the pathogenetie condition and medical condi-tion, in order to make the best treatment perseription for patient under the condition of nomudization.
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In the 20th century, major progresses were made for treatment of hepatocellular carcinoma: standard resection, radiotherapy and chemotherapy were applied in the 1950s; liver transplantation emerged in the 1960s, and the positive clinical results for the treatment of hepatocellular carcinoma were proved in the 1990s; the survival rates were significantly increased due to local resection for small liver cancer in the 1970s and local tumor therapies benefited the patients more in the 1980s. But the purpose of these procedures was only to destroy the tumors. In the past half century, the survival rate of liver cancer patients in our hospital increased every ten years. It is predicted that in the 21st century, the purpose of improving the outcome of treatment for liver cancer will elaborate to manipulating procedures between tumor and the human body on the basis of destroying the tumors. There are various ways to improve the therapeutic results for hepatocellular carcinoma. For example, these efforts can be achieved by developing and using new therapeutic methods. In the early 21st century, further biological study is the key point to influence the clinical progress for hepatocellular carcinoma. Although to destroy the tumors is basic and important, the most important thing is how to regulate the relationship between residual tumors and the human body.
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Chemotherapy plays an important role in advanced colorectal cancer. Patients may show various clinical response to selection different drugs. The importance of individual therapy based on pharmacogenomics has been emphasized in cancer therapy. To explore the individual therapy of colorectal cancer,the progress of molecular markers which influence the efficacy of anti-tumor drugs containing fluorouracil,oxaliplatin,CPT-11,monoclonal antibody drugs is reviewed in this article.